Use of statins for the treatment of spontaneous intracerebral hemorrhage: Results of a pilot study
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Background and Study Aims: Spontaneous intracerebral hemorrhage (ICH) represents the most fatal kind of stroke, and there is still no treatment available that improves the outcome. Statins are cholesterol reducers, and during the last few years many additional effects have been demonstrated that might be neuroprotective. We designed a pilot clinical study in order to evaluate whether the administration of statins is associated with a better outcome. Patients and Methods: From August to December 2006 we carried out a prospective/ retrospective non-randomized clinical study. The prospective group was treated with rosuvastatin (20 mg) and the retrospective control group was taken from our clinical records with a relation of 1:3. We included patients of both sexes, aged ≥15 years with proven ICH in CT-scan. Exclusion criteria were a history of neoplasm, head injury four weeks before admission, non-hypertensive reasons, brainstem hemorrhage, steroid administration, cranial surgery, initial hydrocephalus, and NIHSS ≥ 30. Results: We analyzed 18 patients treated with rosuvastatin and 57 controls with similar basic characteristics. The mortality rate during hospitalization was 1 (5.6 %25) patient in the statin group and 9 (15.8%25) in the control group; the hazard ratio adjusted by the initial Glasgow Coma Scale (GCS), intubation, admission in intensive care unit, disruption into the subarachnoid space was 0.20 (95%25 CI 0.02-1.67). The odds ratio for NIHSS ≥ 15 at release was 0.04 (95%25 CI 0.0030.93). Conclusions: The use of statins during the acute phase of ICH could be associated with a better outcome. Further clinical trials are necessary to confirm a possible therapeutic effect and evaluate the toxicity of statins. © Georg Thieme Verlag KG Stuttgart.
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Hemorrhage; Intracerebral; Neuroprotection; Statins anticonvulsive agent; beta adrenergic receptor blocking agent; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; diuretic agent; hydroxymethylglutaryl coenzyme A reductase inhibitor; mannitol; rosuvastatin; adult; aged; article; brain hemorrhage; brain infarction; clinical study; clinical trial; computer assisted tomography; control group; controlled study; drug use; female; Glasgow coma scale; hazard ratio; hospital admission; hospitalization; human; intensive care unit; intubation; major clinical study; male; medical record; mortality; outcome assessment; pilot study; pneumonia; prospective study; retrospective study; risk; sex; subarachnoid space; therapy effect; Adult; Aged; Antihypertensive Agents; Cerebral Hemorrhage; Female; Fluorobenzenes; Glasgow Coma Scale; Hospital Mortality; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Middle Aged; Odds Ratio; Pilot Projects; Proportional Hazards Models; Prospective Studies; Pyrimidines; Retrospective Studies; Sample Size; Stroke; Sulfonamides; Tomography, X-Ray Computed; Treatment Outcome
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